Questions from a Reader on sorting out access to health care after retirement

Q&A from a Reader

First, thank you so much for your blog.

The first time I contacted you, I was asking for advice on how to convince my husband to pick up our stakes and move to Mexico. I think it was about two years ago. In fact, you used my emailed question in a blog article soon after.

Well guess what- we have been living in Tijuana for almost 6 months!  There have been many changes and hurdles that we are overcoming, and right now I think I could use some of your wisdom.

My husband is disabled and on Medicare, so he is covered as far as health insurance is concerned. I work remotely for an American company and pay insurance premiums for insurance I can’t use- it is an HMO that covers the Virginia area, where we were located before. During open enrollment next February I can switch to a very expensive PPO plan.

I have been researching other options and am just getting more confused and frustrated. I am reading your blog right now regarding insurance, but still at a loss.

I could surely use some guidance and focus and direction in this. I hope you can at least help me narrow down the possibilities that would work for me.

I look forward to hearing from you.

Again, thank you both for all that you have shared over the years- it has been so helpful!



Hi Rachel,

Thanks for taking the time to write.

Congratulations on your move to Tijuana! I hope you are enjoying your new location…

First, let me say that the access-to and paying-for health care topic is complex. Not only that, but it is very personal and each one of us has to decide which approach works best for us.

I have a couple of questions for you that might get your ideas rolling —

You mention that you are living in Mexico — but your husband is on Medicare. You did know that Medicare is only useful to you if you are living in the States? Of course, I could be wrong, since Tijuana is so close, perhaps that city takes Medicare payment or they have an agreement with the US.  Or perhaps you thought in order to obtain health care service, you would simply cross the border into the US.

You might consider applying for Mexican residency (you don’t have to give up your American citizenship, and you would still keep your American passport). In this way, you would be eligible for the Mexican National Insurance Program (Seguro Popular). You don’t mention your age, but if you are fairly healthy (no pre-existing conditions) Mexico also has IMSS which is a higher quality health care for residents. You could apply for that also – but you can only be on one of the systems, not both.

You could perhaps develop a personal HSA and instead of paying for US-based insurance — put your insurance premiums into an account, and then draw from that. Then you could take advantage of Mexico’s hospitals and clinics, paying out of pocket. — For instance, if you pay $10,000 yearly for your US-based health insurance you would simply “Go Naked” and place that previously-used-money-for-premiums into an account earmarked for health care. There is a lot of medical care you can get in Mexico for $10-$20 thousand dollars.

At some point you would qualify for Medicare yourself, and the years you have placed that money into an account for care would accumulate until you qualify and have Medicare take over. And you would still have that money, instead of paying an insurance company for coverage. (See Buying Medical Care vs Buying Medical Insurance )

You didn’t mention if you are healthy or have health issues, but in either case, you must have already seen the price differences between prescriptions and office visits in Tijuana versus the States.

Of course, you could take a look at our Medical Health Insurance Page and look for a policy that is world-wide. And I would suggest taking a look at these articles below for insight, as well as taking a look at our Medical Tourism Page.

Rachel, I think it’s a matter at looking at your options, and then deciding what your risk tolerance is, and how much you want to pay to access medical care.

Let us know if you have any other questions. I hope you find the information that I have given to you to be useful.

Thanks again for taking the time to write.



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About Retire Early Lifestyle

Billy and Akaisha Kaderli retired three decades ago at the age of 38 and began traveling the world. As recognized retirement experts and internationally published authors on topics of finance and world travel, they have been interviewed about retirement issues by The Wall Street Journal, Kiplinger's Personal Finance Magazine, The Motley Fool Rule Your Retirement newsletter, nationally syndicated radio talk shows and countless newspapers and TV shows nationally and worldwide. They wrote the popular books The Adventurer's Guide to Early Retirement (Your Simple Path to FIRE) and Your Retirement Dream IS Possible.
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